PREGNANCY OUTCOMES IN WOMEN WITH PREEXISTING AND GESTATIONAL DIABETES MELLITUS”

Dr Mounika Anitha Chintala, Dr Lakshmi Prasad KK, Dr Mythili Ayyagari

Abstract

Context: Diabetes in pregnancy is increasing and associated with increased risk of complications. There is little data on whether the pregnancyoutcomes have changed over time.Aim: The aim is to compare rates of pregnancy outcomes between women with preexisting diabetes and gestational diabetes (GDM).Settings and Design: This was a prospective observational study done in women with preexisting diabetes and GDM.Methods and Material: Baseline characteristics and medical comorbidities were recorded. Women were counseled regarding life stylemodification (LSM) and glycemic goals. Metformin and/or insulin were used accordingly. Maternal outcomes and neonatal outcomes wereassessed.Results: Out of 183 subjects who were enrolled, 74 (40 %) were women with preexisting diabetes and 109 (60%) were GDM. More than 50% ofpatients required combination of LSM, metformin and insulin in both groups. Pregnancy weight gain was higher in GDM (11.15±3.48) comparedto preexisting diabetes (10.07±3.25; p<0.05). Preterm delivery was more in preexisting diabetes (43.28%) than GDM (25.24%; p=0.01). Therewere higher miscarriages in preexisting diabetes compared to GDM (p=0.02) whereas intra uterine deaths were similar in both groups. Prevalenceof PIH was 26.86% in preexisting diabetes and 15.53% in GDM (p=0.08). Caesarean section rate was 89.55% in preexisting diabetes and 87.37%in GDM. Birth weight was higher in neonates of GDM compared to preexisting diabetes (3.05±0.42 versus 2.88±0.52, p=0.02). There were fourneonates with congenital malformations in preexisting diabetes and none in GDM.Conclusions: The present study in women with Preexisting Diabetes and GDM showed higher miscarriages and higher preterm deliveries inpreexisting diabetes. There were high rates of caesarean section, reduced macrosomia and lesser congenital malformations in the present study.